Chen Fang, Hui Timothy S K, Ma Lingyu, Nong Yaqing, Han Ying, Jing Haiman, Lee Eric K W, Xu Zhiyuan, Fu Pingfu, Chang Amy Tien Yee, Hsue Victor, Kong Feng-Ming Spring
Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Front Oncol. 2022 Feb 3;12:811794. doi: 10.3389/fonc.2022.811794. eCollection 2022.
Application of hypofractionated radiotherapy (HFRT) is growing in patients with breast cancer (BC). This study aimed to explore a real-world practice of HFRT in early and locally advanced BC.
Patients with invasive BC between 2015 and 2019 were retrospectively reviewed. Radiotherapy (RT) was delivered by HFRT and conventionally fractionated radiotherapy (CFRT). Locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS) were calculated by Kaplan-Meier curve and compared by Log-rank test. The effect of treatment modality on DFS was estimated by univariate and multivariable analyses.
A total of 1,010 patients were included in this study, and 903 (89.4%) were treated with HFRT. At a median follow-up of 49.5 months, there was no significant difference in a 4-year cumulative incidence of LRRFS in HFRT group (1.5%) and in CFRT group (3.8%) (p = 0.23), neither in different nodal stages nor in N2-3 patients with different molecular subtypes. The 4-year DFS was 93.5% in HFRT group compared with 89.9% in CFRT group with no significant difference either (p = 0.17). Univariate and multivariable analyses also showed no significant difference in DFS between HFRT and CFRT group. However, DFS of HFRT group tended to be lower in N2-3 patients with triple negative BC compared with that of CFRT group (76.2% versus 100%).
HFRT can achieve similar cumulative incidence of LRRFS and DFS in patients with BC after lumpectomy or mastectomy, and also in different nodal stage, and in locally advanced stage with different molecular subtypes.
在乳腺癌（BC）患者中，短程分割放射治疗（HFRT）的应用正在增加。本研究旨在探讨HFRT在早期和局部晚期BC中的实际应用情况。
回顾性分析2015年至2019年期间的浸润性BC患者。放疗（RT）采用HFRT和常规分割放疗（CFRT）。通过Kaplan-Meier曲线计算局部区域无复发生存期（LRRFS）和无病生存期（DFS），并通过对数秩检验进行比较。通过单因素和多因素分析评估治疗方式对DFS的影响。
本研究共纳入1010例患者，其中903例（89.4%）接受了HFRT治疗。中位随访49.5个月时，HFRT组的4年LRRFS累积发生率（1.5%）与CFRT组（3.8%）无显著差异（p = 0.23），在不同淋巴结分期以及N2-3不同分子亚型的患者中均如此。HFRT组的4年DFS为93.5%，CFRT组为89.9%，同样无显著差异（p = 0.17）。单因素和多因素分析也显示HFRT组和CFRT组在DFS方面无显著差异。然而，三阴性BC的N2-3患者中，HFRT组的DFS倾向于低于CFRT组（76.2%对100%）。
HFRT在保乳手术或乳房切除术后的BC患者中，以及在不同淋巴结分期、不同分子亚型的局部晚期患者中，均可实现相似的LRRFS和DFS累积发生率。
